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  • 11/02/2018 10:59 AM | Anonymous

    November 2, 2018, Wisconsin Medical Society Medigram  

    The Centers for Medicare and Medicaid Services (CMS) announced yesterday its approval for Wisconsin’s 1115 Medicaid demonstration waiver. The approved waiver makes Wisconsin the fourth state to implement work requirements for its childless adult population (adults between the ages of 19 and 64). The initial waiver application also included drug testing requirements, but CMS did not approve those provisions.

    The approved waiver also includes the following provisions:

    • Limits eligibility for childless adults to 48 continuous months for those who do not meet specified obligations such as work requirements, education or job training or do not have a specified exemption. At the end of the 48 months, the enrollee will lose Medicaid eligibility for 6 months, at which time they could re-enroll in Medicaid and the 48-month clock would restart.
    • Establishes monthly premiums of $8 per household (or less depending on income and healthy behaviors).
    • Requires members to complete a health and wellness questionnaire. Monthly premiums for enrollees who complete the questionnaire will be cut in half.
    • Expands coverage of residential treatment for substance use disorder.
    • Establishes an emergency department (ED) copayment of $8 for non-emergency use of the ED. If enrollees appropriately use the ED for an emergency health issue they will not be charged a copay.
    • Discontinues premiums for parents and caretaker relatives who qualify for transitional medical assistance.

     
    The Wisconsin Medical Society commented on all these proposals in its May 2017 letter, which expressed concerns about potential impacts on patients and physicians, while offering support for expansion of substance use disorder treatment. The Society’s House of Delegates also passed policy on the waiver during its 2018 meeting last April.

    1332 Waiver

    In addition to its action on the 1115 waiver, last week CMS issued new guidance on 1332 waivers. The new guidance, which went into effect immediately, loosens existing guardrails on the 1332 waiver process. States will no longer be required to demonstrate that their 1332 waiver would cover the same amount of people as would be required absent the waiver, only that the same number of people would have access to coverage. Further, access could be defined as acquiring coverage from a short-term limited duration health plan or an association health plan, which do not have to adhere to Affordable Care Act patient protections.

    Contact the Society’s Manager of Advocacy and Regulatory Affairs H.J. Waukau if you have questions about either waiver.


  • 10/26/2018 10:29 AM | Anonymous

    October 26, 2018, Wisconsin Medical Society Medigram  

    The Trump Administration this week proposed a new rule that would allow employers to offer employees tax-preferred health reimbursement accounts (HRA) as an alternative to traditional health insurance.

    The rule is intended to provide businesses a way to support their employees’ healthcare expenses without requiring employers to shoulder the administrative and financial burdens of offering health plans.

    HRAs have been a fixture of employer-based health plans, often as a supplement to existing employer-based insurance. Under the proposed rule, HRAs could be used to satisfy the Affordable Care Act’s employer mandate, as employers could direct HRA funds to help pay for employee coverage on the individual insurance market. The rule also creates an option for employees to use HRA funds to pay for premiums for a short-term limited duration plan (up to a total of $1,800 per year), provided that the employer also offers a group plan that is not an HRA.

    The Administration estimates that 800,000 employers will use HRAs as a way to provide coverage for approximately 10 million employees. See this Fact Sheet for more information.

    The Wisconsin Medical Society will prepare and offer comments on proposal. Contact H.J. Waukau, manager of advocacy and regulatory affairs if you have questions.

    Source: WMS Medigram 


  • 10/12/2018 11:00 AM | Anonymous

    October 12, 2018, Wisconsin Medical Society Medigram  

    Nominations are now being accepted for several Wisconsin Medical Society offices, and all nomination materials are due to the Society’s House of Delegates (HOD) Nominating Committee by Wednesday, Jan. 2, 2019. 

    Read more.

  • 09/17/2018 9:24 AM | Anonymous

    Join us Oct. 9 for our annual insurance CEO roundtable. Leaders will discuss the most pressing issues facing their industry, including the fate of the Affordable Care Act, prescription drug prices, value-based payments and more.

    Panelists:

    • Coreen Dicus-Johnson, CEO, Network Health
    • Dustin Hinton, CEO, UnitedHealthcare of Wisconsin
    • Cathy Mahaffey, CEO, Common Ground Healthcare Cooperative

    The event is Tuesday, October 9 at the Wisconsin Club in Milwaukee (11:30am – 1pm).  Register now (link).


  • 07/16/2018 10:45 AM | Anonymous

    The annual Wisconsin Health News CEO Roundtable is August 14 in Madison. A panel of the state’s leading health system and hospital leaders will discuss the most pressing issues facing their industry.

    Panelists include:

    • Dr. Sue Turney, CEO, Marshfield Clinic Health System
    • Robert Van Meeteren, CEO, Reedsburg Area Medical Center
    • Dr. Alan Kaplan, CEO, UW Health

    Register now (link).


  • 06/27/2018 2:09 PM | Anonymous

    WMS Medigram Alert - June 27, 2018  

    In a decision released this morning, the Wisconsin Supreme Court restored the state’s $750,000 cap on noneconomic damages in medical liability cases.

    The decision in Mayo v. Wisconsin Injured Patients and Families Compensation Fund reverses a 2017 Court of Appeals decision that struck down the cap, which has been integral to Wisconsin’s well-balanced medical liability system and patients’ access to care since 2005.

    “We are very pleased with today’s decision,” said Society President Molli Rolli, MD, in this press release . “The Court clearly understands the importance of the cap to our state’s unique and comprehensive medical liability system—a system that provides unparalleled benefits to both patients and physicians.”

    The wisconsin Medical Society has been a strong and vocal proponent of the cap since it was created, and in the Mayo case, submitted three separate briefs—jointly with the AMA Litigation Center—articulating the important benefits of the cap as part of Wisconsin’s comprehensive medical liability system.

    “The cap helps our state attract and retain top quality physicians and keep medical costs in check, and ultimately ensures Wisconsin citizens’ access to high quality care,” said Society CEO Bud Chumbley, MD.

    Click here to read the press release in its entirety.
  • 05/21/2018 5:34 PM | Anonymous

    Join us June 12 for a Newsmaker Event with Mayo Clinic Vice President Dr. Bobbie Gostout. As the leader of Mayo Clinic Health System, Gostout oversees the organization’s hospitals in Wisconsin, Minnesota and Iowa. 

    11:45 a.m. -1:00 p.m. 

    Register here. 

  • 04/23/2018 3:12 PM | Anonymous

    Wisconsin continues to grapple with the opioid epidemic. Emergency departments in the state saw suspected opioid overdoses more than double between July 2016 and last September, according to recent federal data. While Wisconsin has taken steps to fight the crisis, more work remains. A Wisconsin Health News panel will take a closer look at the challenges facing those seeking treatment and how to boost access.

    Panelists include:

    • Paul Krupski, Director of Opioid Initiatives, Department of Health Services
    • Rep. John Nygren, R-Marinette
    • Andrew Whitacre, Senior Associate, Pew Charitable Trusts
    • Dr. Aleksandra Zgierska, Assistant Professor, UW Department of Family Medicine and Community Health 

    Register here


  • 03/26/2018 10:13 AM | Anonymous
    March 23, 2018 - Wisconsin Medical Society Insurance and Financial Services

    The Injured Patients and Families Compensation Fund (Fund) Board this week approved a 10 percent decrease in Fund fees for the 2018-2019 fiscal year. This is the sixth decrease approved by the Fund Board in as many years.

    Wisconsin’s excellent medical liability environment is good for your organization’s business: money not spent to obtain coverage and settle claims can be allocated to improve quality and the overall patient experience.

    Your Wisconsin Medical Society (Society) continues to work vigilantly to preserve Wisconsin’s relatively stable medical liability environment, most recently by filing amicus briefs at both the appellate and Supreme Court level in Mayo v. the Injured Patients and Families Compensation Fund—a case that has challenged the constitutionality of the state’s cap on noneconomic damages in medical liability cases. We are also maintaining our active involvement in the primary insurance market, working with our exclusive partner, ProAssurance. Additionally, the WMS Holdings Risk Purchasing Group and Captive are designed to help health systems decrease liability costs and improve quality and efficiency.

    The Society was influential in obtaining this rate reduction through its participation on the Fund Board. This is a great example of how the Society’s advocacy efforts—which the profits generated by Wisconsin Medical Society Insurance & Financial Services help support—benefit the medical community in Wisconsin.

    Don't hesitate to email me or call me at 608.442.3738 if you have any questions about this or for other insurance-related matters. 

    Very truly yours, Shawna Bertalot, President

    Wisconsin Medical Society Insurance and Financial Services


  • 03/26/2018 10:11 AM | Anonymous

     Join us for lunch and discussion with Sen. Leah Vukmir, who chairs the Senate Committee on Health and Human Services. The Brookfield Republican will talk about the past session's major health-related initiatives and what's next for healthcare in the state.   

    Register here. 

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